The cell-based approach in neurosurgery: ongoing trends and future perspectives
Sabino Luzzi,
Alberto Maria Crovace,
Mattia Del Maestro,
Alice Giotta Lucifero,
Samer K. Elbabaa,
Benedetta Cinque,
Paola Palumbo,
Francesca Lombardi,
Annamaria Cimini,
Maria Grazia Cifone,
Antonio Crovace,
Renato Galzio
Affiliations
Sabino Luzzi
Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Polo Didattico ''Cesare Brusotti'', Viale Brambilla, 74, Pavia, 27100, Italy; Neurosurgery Unit, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, Viale C. Golgi, 19, Pavia, 27100, Italy; Corresponding author.
Alberto Maria Crovace
Department of Emergency and Organ Transplantation, University of Bari ''Aldo Moro'', Piazza G. Cesare, 11 – Policlinico di Bari, Bari, 70124, Italy
Mattia Del Maestro
Neurosurgery Unit, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, Viale C. Golgi, 19, Pavia, 27100, Italy; PhD School in Experimental Medicine, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Polo Didattico ''Cesare Brusotti'', Viale Brambilla, 74, Pavia, 27100, Italy
Alice Giotta Lucifero
Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Polo Didattico ''Cesare Brusotti'', Viale Brambilla, 74, Pavia, 27100, Italy
Samer K. Elbabaa
Pediatric Neurosurgery, Pediatric Neuroscience Center of Excellence, Arnold Palmer Hospital for Children, 1222 S. Orange Avenue, 2nd Floor, MP 154, Orlando, FL, 32806, USA
Benedetta Cinque
Department of Life, Health & Environmental Sciences, University of L'Aquila, Building Delta 6, via Coppito, L'Aquila, 67100, Italy
Paola Palumbo
Department of Life, Health & Environmental Sciences, University of L'Aquila, Building Delta 6, via Coppito, L'Aquila, 67100, Italy
Francesca Lombardi
Department of Life, Health & Environmental Sciences, University of L'Aquila, Building Delta 6, via Coppito, L'Aquila, 67100, Italy
Annamaria Cimini
Department of Life, Health & Environmental Sciences, University of L'Aquila, Building Delta 6, via Coppito, L'Aquila, 67100, Italy
Maria Grazia Cifone
Department of Life, Health & Environmental Sciences, University of L'Aquila, Building Delta 6, via Coppito, L'Aquila, 67100, Italy
Antonio Crovace
Department of Emergency and Organ Transplantation, University of Bari ''Aldo Moro'', Piazza G. Cesare, 11 – Policlinico di Bari, Bari, 70124, Italy
Renato Galzio
Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Polo Didattico ''Cesare Brusotti'', Viale Brambilla, 74, Pavia, 27100, Italy; Neurosurgery Unit, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, Viale C. Golgi, 19, Pavia, 27100, Italy
Objective: Examination of the current trends and future perspectives of the cell-based therapies in neurosurgery. Methods: A PubMed/MEDLINE-based systematic review has been performed combining the main Medical Subject Headings (MeSH) regarding the cell- and tissue-based therapies with the “Brain”, “Spinal Cord”, “Spine” and “Skull” MeSH terms. Only articles in English published in the last 10 years and pertinent to neurosurgery have been selected. Results: A total of 1,173 relevant articles have been chosen. Somatic cells and gene-modification technologies have undergone the greatest development. Immunotherapies and gene therapies have been tested for the cure of glioblastoma, stem cells mainly for brain and spinal cord traumatic injuries. Stem cells have also found a rationale in the treatment of the cranial and spinal bony defects, and of the intervertebral disc degeneration, as well.Most of the completed or ongoing trials concerning the cell-based therapies in neurosurgery are on phase 2. Future perspectives involve the need to overcome issues related to immunogenicity, oncogenicity and routes for administration. Refinement and improvement of vector design and delivery are required within the gene therapies. Conclusion: The last decade has been characterised by a progressive evolution of neurosurgery from a purely mechanical phase to a new biological one. This trend has followed the rapid and parallel development of translational medicine and nanotechnologies.The introduction of new technologies, the optimisation of the already existing ones, and the reduction of costs are among the main challenges of the foreseeable future.
